Drug-induced block of cardiac HERG potassium channels and development of torsade de pointes arrhythmias: the case of antipsychotics

J Pharm Pharmacol. 2005 Feb;57(2):151-61. doi: 10.1211/0022357055272.

Abstract

The prolongation of the cardiac repolarization process, a result of the blocking of the Human Ether-ago-go Related Gene potassium channel, is an undesired accessory property shared by many pharmacological classes of non-cardiovascular drugs. Often the delayed cardiac repolarization process can be identified by a prolongation of the QT interval of the electrocardiograph. In these conditions, premature action potentials can trigger a dangerous polymorphic ventricular tachyarrhythmia, known as torsade de pointes, which occasionally can result in lethal ventricular fibrillation. In this work, brief descriptions of the electrophysiological basis of torsade de pointes and of the several pharmacological classes of torsadogenic drugs are given. Attention is focused on antipsychotics, with a deeper overview on the experimental and clinical reports about their torsadogenic properties.

Publication types

  • Review

MeSH terms

  • Animals
  • Antipsychotic Agents / adverse effects*
  • Antipsychotic Agents / classification
  • Antipsychotic Agents / therapeutic use
  • Humans
  • Italy
  • Potassium Channels, Voltage-Gated / antagonists & inhibitors*
  • Potassium Channels, Voltage-Gated / drug effects*
  • Torsades de Pointes / chemically induced*
  • Torsades de Pointes / physiopathology

Substances

  • Antipsychotic Agents
  • Potassium Channels, Voltage-Gated